Individual
LOUIS BEDOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
33727 S COLONY DR, RED ROCK, AZ 85145-5044
(520) 404-2232
Mailing address
33727 S COLONY DR, RED ROCK, AZ 85145-5044
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
7173970
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7173970
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
04/03/2019
Last updated
04/03/2019
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